psych exam 1

effects of anticholinergic medications

blocks “rest & digest” →

dry mouth, blurred vision, constipation, urinary retention/hesitancy, memory dysfunction, tachycardia

Milieu therapy

what it is→ therapy that uses the mental health environment and interactions between patients as part of the therapy

test answer→ “I understand you’re frustrated, let’s find a resolution”

what is considered assault and battery?

test answer→ nursing using restraints w/o consent

how to confront an aggressive patient

focus: deescalation and safety→

remain calm and controlled; use therapeutic communication; set clear/simple limits; acknowledge/validate patient’s feelings; give the patient space; do not threaten, argue, or challenge patient; maintain safety; use the least restrictive intervention first

appropriate use of four-point restraints

LAST resort to maintain safety when a patient poses an immediate danger and less-restrictive methods did not work; must be justified by safety and clinical necessity

what is the organization of patient care called?

*multiple choice question; test answer→ Care Coordination

Infant Erikson theory

Trust vs Mistrust→ “Can I trust that my needs will be met”

-when the caregiver provides consistent food, warmth, comfort, safety, and care→ trust and hope

-care is inconsistent, neglectful, or unpredictable→ mistrust

SSRI black box warning

can increase the risk of suicidal thoughts and behaviors in children, adolescents, and young adults, especially when starting the treatment or changing the dose

what are neurotransmitters?

chemical messengers that allow neurons (nerve cells) to communicate with each other

*test question won’t ask for specifics, just literally what are they

proportion of how many nurses get assaulted by patients

test answer→ 1 in 4 nurses

What triggers complicated grief?

*more likely to occur when the loss is especially traumatic or when the person has limited emotional and social resources for coping

triggers/risk factors→ sudden/unexpected death; violent or traumatic death; death of a loved one (spouse, child, parents during adolescence); multiple deaths/losses close together; very close relationship with the deceased; previous psychiatric or mental health problems; previous suicide thoughts or attempts; low-esteem or low-trust in others; absent/unhelpful family/social support

biggest risk of combining MAOIs and tyramines

test answer→ hypertensive crisis

what is considered a situational crisis?

test answer→ job loss

*remember a situational crisis is an unexpected, stressful life event (ex: job loss, divorce, major financial problems, death of a loved one)

what classification of drug is chlorpromazine?

drug class→ typical (first-generation) antipsychotic

main action→ blocks dopamine D2 receptors

used for→ psychotic symptoms, particularly the positive symptoms of schizophrenia

what is lithium used for?

mania

why→ lithium is a mood stabilizer that helps control the elevated mood and behavioral symptoms associated with bipolar mania

physiological symptoms of grief

test choices→ appetite loss, weight gain, palpitations

-palpitations was highlighted on pic, but correct answer based off of class material is appetite loss

what falls under a breach of confidentiality?

test situation→ student uses full name in report, what should the teacher do?→ teacher should address the student and have the identifying information removed/replaced with a non-identifying identifier (ex: initials)

*key concept of breach of confidentiality: protecting the client’s privacy and not using identifying information when discussion or reporting patient information

who is not given the right to refuse treatment?

patients do not have the right to refuse when the situation is an emergency or is a court order or deemed incompetent

test options remembered→

-patient deemed incompetent by court (correct answer out of these two)

-patient who is involuntarily committed (incorrect- involuntarily committed does not automatically mean their right to refuse gets taken away)

Kubler Ross stages

test answer→ all of the above

stages:

D- denial

A- anger

B- bargaining

D- depression

A- acceptance

(aripiprazole) Abilify drug classification

atypical (second generation) antipsychotic used for acute mania and as a mood stabilizer

patient is projecting, what is projection used as?

test situation→ patient is using projection as a defense mechanism

projection→ “it’s not me, it’s you”

-when the patient is experiencing a feeling or thought that is uncomfortable/unacceptable, they blame or attribute it to another person instead of recognizing it as their own to protect themselves from anxiety

coping and defense mechanisms

*multiple choice; test options remembered→

-defense mechanisms are subconscious and adaptive mechanisms (correct; they protect the person from unwanted anxiety and from emotional conflict and stressors)

-defense mechanisms reduce depression and anxiety (incorrect)

-problem focused coping is characterized by the search for higher meaning (incorrect, this would be emotion-focused coping)

what are the most basic needs for Maslow’s?

*question asks which 2 of the choices are correct

test options remembered→

-patient seeking shelter at Mabuse shelter (correct; this is a basic/physiological need)

-patient who is looking for religion (incorrect; this is a higher-level need, related to meaning and spirituality)

-patient who is looking for freedom from fear (correct; this is a safety and security need)

-patient who is learning to love self (incorrect; this is an esteem need)

what is the definition of culture?

textbook definition→ way of life shared by people who identify or associate with one another based on a common purpose, need, or similarity of background. It also includes the totality of learned, socially transmitted beliefs, values, and behaviors that develop through interpersonal interactions.

simplified definition→ learned and socially shared beliefs, values, behaviors, and ways of life of a group of people

sentences that are more likely to come from a violent person

*test will ask which 3 are correct

test options remembered→

- ”man has the right to fight” (correct; suggests fighting/physical aggression is justified)

- ”i have a right to be angry, and i am angry” (correct; openly acknowledges intense anger)

- ”people will push me, but they can only push me so far” (correct; suggests a threat/escalation)

- ”this nurse sucks and you are all monkeys” (incorrect; is an insult/verbal hostility, but does not indicate physical aggression or violence by itself)

which population would most likely experience mental illness?

*multiple choice; test options remembered→

-adolescents

-older adults

-low income people

what is obstructive intervention?

test answer→ minimize patient’s concerns

obstructive intervention is a communication technique that blocks or interferes with effective communication (ex: giving advice, changing the subject, judgmental responses, not following the patient’s lead, minimizing/dismissing patient’s feelings, asking questions in a way that interferes with communication)

meds affect the extrapyramidal track (im guessing question is abt extrapyramidal symptoms or which meds cause the symptoms)

extrapyramidal symptoms (EPS)→ movement-related side effects caused by antipsychotic meds, especially typical (first generation antipsychotics)

-acute dystonia→ sudden muscle spasms, rigidity (often in neck, jaw, eyes, or tongue)

-pseudoparkinsonism→ shuffling gait, tremor, slowed movement, mask-like expression

-akasthisia→ restlessness, pacing, patient cannot sit still

-tardive dyskinesia→ involuntary, repetitive movements (lip smacking, tongue protrusion); can be irreversible

nurse greets patient with open body language (im guessing question is about therapeutic communication)

*SATA question- 3 will be right; test options remembered→

-trust

-offer silence

-offer hope and humor

-reluctance to communicate

termination/resolution phase of Peplau’s

test answer picked→ patient summarizes own accomplishments

what’s included in this phase→ patient is now more independent; the patient applies what they learned; pt prepares for life w/o the nurse; follow-up care is arranged; community resources provided; new behaviors are practiced; nurse helps pt recognize signs of relapse and pt uses newly learned skills; pt may strengthen relationships with significant others

rule of confidentiality concept regarding self-help groups

test option remembered→ you see a family friend in group and talk about it with your family (maybe the question is about what reflects a breach of confidentiality)

-talking about it with your family is wrong because you have now revealed private information about the person’s participation in that group

“What happens in the group, stays in the group”

patient suicide precautions

*SATA question; test options remembered→

-no light bulbs/mirrors

-no shoelaces

-no chargers/cables

-pt can have paper and booklets

patient is threatening self-harm due to possession by devil, what is the best response

test options remembered→

-”We have a chaplain who can talk to you while someone watches you”

-”There is no devil”

-”We have a team of professionals who can help you”

-”It seems you are distressed about something, how about we talk about it” (acknowledges the emotion without validating the delusion + encourages pt to talk about what they are experiencing)

nurse is saying stuff like “I see,” “Yes,” “Go on.” what is the nurse practicing?

test answer chosen→ reinforcement

what textbook/class material says→ those statements show the nurse is offering general leads to encourage the patient to continue talking while allowing the patient to remain in control of the conversation

what is the purpose of CBT

test options remembered (not full options remembered)→

-“Substitute rational for irrational” (chat says this is good way to think about it”

-”…end behavioral…”

CBT helps patients recognize and change distorted or negative thinking patterns so they can develop healthier emotional responses and behaviors

which of the following is not part of the cognitive triad for CBT?

test answer→ beliefs people have about spirituality

what’s actually included in the triad:

-self→ “I am worthless”

-the world/environment→ “Everything around me is bad”

-the future→ “Nothing will ever get better”

*purpose of the triad for CBT→ identify these negative/inaccurate thought patterns and replace them with more realistic thoughts

as a nurse, what shouldn’t you be to a patient in terms of nurse-pt relationship

test options remembered→

-friend/socializer

-therapist

-role model

-teacher

*the nurse-pt relationship is a professional therapeutic relationship, not social or friendship relationship

patient is sticking out tongue and has a protruding mouth, what extrapyramidal symptom is this?

test answer→ tardive dyskinesia

which of the following statements are true as they relate to the history of psychopharmacology?

*SATA question, but only lets you pick 2

test answers→

- ”Newly developed atypical psychotropics have shown much more promise in controlling the negative symptoms of schizophrenia”

”Before the 1950s, only sedatives and amphetamine were available as psychotropics”

“the duty to benefit or promote the good of others”- what is this the definition of?

test answer→ beneficence